Soft tissue sarcomas (STSs) are rare heterogeneous malignancies of mesenchymal origin. Pulmonary metastases develop in approximately 50% of the patients with high-grade STS, being the major cause of mortality in patients with metastatic STS. Pulmonary metastasectomy has been reported to contribute to long-term survival; however, an appropriate treatment has not been established. We aimed to identify factors associated with post-metastasis survival in STS patients with pulmonary metastasis and determine the appropriate treatment for each patient. We retrospectively reviewed the records of metastatic STS patients treated between 2000 and 2017 and analyzed the clinico-pathologic variables to identify factors associated with the survival. The median survival after pulmonary metastasis was 20.6 months, and the 1-, 3-, and 5-year survival rates were 68.6%, 36.0%, and 25.1%, respectively. The survival was significantly greater in patients who underwent pulmonary metastasectomy than in those without surgery (38.9 months vs. 10.5 months; p < 0.0001). Among those who did not undergo surgery, the survival was significantly greater in patients who received chemotherapy than in those without chemotherapy (19.1 months vs. 6.3 months, p = 0.037). Multivariate analysis identified pulmonary metastasectomy as the most important prognostic factor for post-metastasis survival (Hazard ratio 5.623; 95% Confidence Interval 2.733-11.572; p < 0.0001). In conclusion, pulmonary metastasectomy was the most important prognostic factor for post-metastasis survival in patients with metastatic STS. In addition, chemotherapy could prolong survival in patients who were not eligible for pulmonary resection. Although we should carefully weigh the risks and benefits, appropriate treatment for pulmonary metastases could contribute to long-time survival.

中文翻译：

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治疗方法对软组织肉瘤患者肺转移的预后影响。

软组织肉瘤（STS）是间充质起源的罕见异质性恶性肿瘤。高度转移性STS患者中约有50％发生肺转移，这是转移性STS患者死亡的主要原因。肺转移术据报道有助于长期生存。但是，尚未建立适当的治疗方法。我们旨在确定与STS肺转移患者转移后存活相关的因素，并确定每位患者的适当治疗方法。我们回顾性研究了2000年至2017年间治疗的转移性STS患者的记录，并分析了临床病理变量以确定与生存相关的因素。肺转移后的中位生存期为20.6个月，一年，三年和五年的生存率为68。分别为6％，36.0％和25.1％。接受肺转移切除术的患者的生存期显着高于未经手术的患者（38.9个月对10.5个月； p <0.0001）。在未接受手术的患者中，接受化疗的患者的生存期明显高于未接受化疗的患者（19.1个月对6.3个月，p = 0.037）。多因素分析表明，肺转移术是转移后生存的最重要预后因素（危险比5.623； 95％可信区间2.733-11.572； p <0.0001）。总之，肺转移瘤切除术是转移性STS患者转移后生存的最重要预后因素。另外，化学疗法可以延长不适合肺切除的患者的生存期。